HEALTHCARE IN

HEALTH CARE: - PREVENTIVE - Sanitation - Clean Water - Nutrition - Maternal Care - Neo-natal Care CURATIVE

THE NON-CURATIVE SYSTEM: TAKING HEALTHCARE TO THE PEOPLE

P P P P P P P P PHC/S PHC/S C P C PHC/S P C P PHC/S P C P CHC PHC/S P C P P PHC/S P P C PHC/S C CHC District CHC P P Hospital P PHC/S PHC/S C P C P CHC P PHC/S P PHC/S CHC: Community Health Centre C P PHC/S C P PHC: Primary Health Centre C P P SC: Sub Centre P P P P: Patients P P P P Total Staff Available at 9 CHCs viz-a-viz IPHS Guidelines

Nos. required as per Total Sanctioned Nos. available at IPHS Guidelines at 9 Posts at 9 CHCs 9 CHCs CHCs

Medical Officer 27 27 18 General Surgeon 9 7 0 Physician 9 7 2 Obstetrician & 9 5 1 Gynecologist Paediatrician 9 3 0 Anaesthetist 9 1 0 Dental Surgeon 9 0 0 Total (Doctors) 81 50 21 Nurses & other 207 90 63 Para-Medical Staff Source: CMHO, Dholpur DHOLPUR Total Staff Available at 27 PHCs viz-a-viz IPHS Guidelines

Nos. required as per Total Sanctioned Nos. available IPHS Guidelines at 27 Posts at 27 PHCs at 27 PHCs PHCs

Doctors 54 37 25

Other Staff 270 262 143

Source:- CMHO, Dholpur

BUILDINGS – 100%, 75-100% AS PER STANDARD PLAN. HEALTHCARE IN INDIA

• THUS: Short “Sanctions” – inadequate funds(exp. As % of GDP) No doctors to recruit!

Dholpur: Required: 135 (CHCS + PHCS) Available: 46 Shortage: 89, say 90 : 90x33 districts= 2970; say 3000 Doctors Actual shortage: 5000 doctors Average annual applicants: 200-250 Postings – Unrealistic expectations!

CAN WE TAKE PEOPLE TO HEALTH CARE ?

• MILK ROUTES • HEALTH ROUTES ?

Proposed P P P P P Approach: P P P P Bring People to Strengthened P CHCs/Health- P P care Hubs

P CHC P o Consolidate P and strengthen P selected CHCs, District P P Hospital & Sub-Division CHC CHC District P Hospital-Bari P Hospital to serve as P ‘Healthcare Hubs’ P P CHC P P o Feed PHC/SC ‘Healthcare P P Hubs’ through Healthcare- P P Vans to cover P P entire district P P P P P

Proposed Solution: ‘Healthcare Hubs’

CHC - Maniya

CHC - Basedi Basai Nawab

Saipau

SDH - Bari

kanchanpur CHC -

DH - Dholpur

CHC - MILKING OUR FEW RESOURCES o GPS-fitted Healthcare-Vans: (1+1+2+1+10) . Manned by para-medical staff . 31 health-routes to cover entire district and at-least 1 return trip per day for each route . Average route length – 55 KM . All gram-panchayats covered (153 nos.) . All en-route and additional villages also covered (385 nos.) . Vans to collect pathological samples and distribute medicines also

Vehicle departs from Healthcare Hubs every MORNING

Patients picked from fixed stops en-route and taken to the Hubs/CHCs

Village Village Village Village Village Healthcare 5 4 3 2 1 Hub/CHC After treatment, patients dropped back to their respective villages Vehicle departs back to respective villages every AFTERNOON Health Routes on District Map NOT MUCH IS REQUIRED

No. of No. of Health Total Route Healthcare Hub Villages Routes Length ( KM) Covered Sarmathura (C-1) 6 383 61 Baseri (C-2) 3 191 84 Maniya (C-3) 8 436 177 Rajakhera (C-4) 5 229 63 Dholpur (C-5) 6 285 95 Bari (C-6) 3 169 58 Total 31 1693 538

6 for PHC to District hospital transportation 6 for emergency and back-up. HEALTHCARE IN INDIA

MONEY MATTERS – • Current Liability Of The State – Staff All 9 Chcs + 27 Phcs In Dholpur As Per IPHS Norm. COST (2013) Rs. 23.5 crores/annum. 2013 expenditure: Rs.10 crores Required: exp. 2.5 times. + 90 MORE doctors! • Alternative Presented Cost Rs. 14 crores Doctors Required : 54 Available : 46 (MIS-MATCHES ARE ANOTHER STORY!)

PARA MEDICS Available : 233 Proposed: 120 at CHCs (2 time IPHS norms) 43 with Healthcare vans. 17 reserve (leave etc) 26 extra to district hospital 206